Tezal Mine, Grossi Sara G, Genco Robert J
Department of Oral Biology, University at Buffalo, Buffalo, NY, USA.
J Periodontol. 2005 Mar;76(3):406-10. doi: 10.1902/jop.2005.76.3.406.
Infections have been suggested in the etiology of oral cancer. This study was carried out to evaluate the effect of periodontal disease on oral soft tissue lesions.
A total of 13,798 subjects aged 20 years and older with at least six natural teeth and who participated in the Third National Health and Nutrition Examination Survey (NHANES III) constituted the study population. Severity of periodontal disease was represented by clinical attachment loss (CAL) and was dichotomized as < or =1.5 mm versus >1.5 mm according to its distributions in the NHANES III population. Three separate dependent variables were employed: 1) tumor (non-specific); 2) precancerous lesions; and 3) any oral soft tissue lesion. The independent effect of CAL on those three dependent variables was assessed by weighted multiple logistic regression analyses adjusting for the effects of number of filled teeth, number of decayed teeth, presence of prosthesis, age, gender, race/ethnicity, education, tobacco, alcohol, occupational hazard, and interaction term "tobacco*occupational hazard." Odds ratios (OR) and their 95% confidence intervals (CI) were calculated.
CAL was not related to the presence of any soft tissue lesion (OR = 1.09, 95% CI: 0.91 to 1.31), but was specifically related to the presence of tumor (OR = 4.57, 95% CI: 2.25 to 9.30) and precancerous lesions (OR = 1.55, 95% CI: 1.06 to 2.27).
This study suggests associations between periodontal disease and the risk for precancerous lesions and tumors generating a hypothesis about a possible relationship between periodontal disease and oral neoplasms. Prospective or well-designed case-control studies with histologically confirmed incident oral cancer cases are necessary to confirm this relationship.
感染被认为与口腔癌的病因有关。本研究旨在评估牙周疾病对口腔软组织病变的影响。
共有13798名年龄在20岁及以上、至少有六颗天然牙且参加了第三次全国健康与营养检查调查（NHANES III）的受试者构成了研究人群。牙周疾病的严重程度以临床附着丧失（CAL）表示，并根据其在NHANES III人群中的分布分为≤1.5毫米和＞1.5毫米两组。采用了三个独立的因变量：1）肿瘤（非特异性）；2）癌前病变；3）任何口腔软组织病变。通过加权多元逻辑回归分析评估CAL对这三个因变量的独立影响，并对补牙数量、龋齿数量、假体存在情况、年龄、性别、种族/民族、教育程度、烟草、酒精、职业危害以及交互项“烟草*职业危害”的影响进行了调整。计算了优势比（OR）及其95%置信区间（CI）。
CAL与任何软组织病变的存在无关（OR = 1.09，95% CI：0.91至1.31），但与肿瘤的存在（OR = 4.57，95% CI：2.25至9.30）和癌前病变（OR = 1.55，95% CI：1.06至2.27）有特定关联。
本研究表明牙周疾病与癌前病变和肿瘤风险之间存在关联，从而提出了关于牙周疾病与口腔肿瘤之间可能关系的假设。需要进行前瞻性或设计良好的病例对照研究，并对组织学确诊的口腔癌新发病例进行研究，以证实这种关系。
